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For Dr. Lupo-RAI Post Therapy Scan
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For Dr. Lupo-RAI Post Therapy Scan

Im from the Philippines and were not that advance in treating Papillary Thryroid CA.  I just undergone Complete Thyrodectomy last Feb. 5, 2008 for my Papillary CA and on March 10, 2008 undergone RAI 131 at 150 mci. I did not take any thyroid med from after my surgery till RAI treatment only after my RAI Whole body scan that i started taking thyroid meds at 50 mg.  This is the result of my RAI 131Post Therapy Whole Body Scan:

Clinical Data:  A 44 year old female status post total thyroidectomy(on feb s5, 2008) for papillary thyroid carcinoma. Referred for total radiodine 131 body scanning to assess thyroid gland ablation and presence of distance metastasis.

Images obtained in the anterior and posterior projections 7 days after an oral dose of 150 mci of iodine 131 show tracer uptake by  residual thyroid parenchyma in the right and left thyroid beds with the following dimensions: 1.6cmx1.5cm (right thyroid fossa); 1.2cmx1.2cm and 1.2cm x 1.1cm (left thyroid fossa).

Physiologic radioiodine activity is seen in the oro/nasopharynx and paired salivary glands with transiting activity in the intestines and urinary bladder.

Focal tracer accumulation are seen in the supraclavicular area and hilar areas of the lungs.

Interpretation:
1.  Small thyroid glands residuals in the anterior region, post RAI therapy (150 mci on 3/10/08)
2.  Distant functioning metastasis in the right supraclavicular area (1.6cmx1.5cm lymph node)
3.  Possible lung metastases vs contamination

My question is except for the lymph node in thyroid which is quite visible in the scan, can it just be a thyroid tissue? , the 2 small dots in the lungs which the doctor says is a possible metastases is so vague and can hardly be seen  especially the anterior scan they did not even measure it . Why so vague? Can it be just my knot in my lab gown or my hair?  Such vague lymph nodes were not seen during my XRAY taken during my surgery.  The nuclear doctor just recommended that a repeat I-131 WBS after 6 months, serum TG and TG antibodies and another chest Xray.  I'm so confused , Are  there any other way to see if my CA already metastasize in my lungs? What should I do? Do I really have to wait for 6 months? When should they take my Tg level and X-ray? What other test should I undergo to see if it really mestasize? I'm so worried? Am I going to die soon?
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393685_tn?1325870933
I feel so bad I can not answer you - I read your other question completely explaining the same thing.

Normally Dr Lupo will not answer on the community board - you need to post this on the expect (doctor) forum.

Hard to get on -- keep trying - he answers all questions - once you get on there.

I bumped up your other question to us though - I hope someone see it with experience and posts back.

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